{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,13]],"date-time":"2026-02-13T12:54:57Z","timestamp":1770987297018,"version":"3.50.1"},"reference-count":44,"publisher":"BMJ","issue":"2","funder":[{"name":"National Children\u2019s Research Centre, Dublin, Ireland"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Arch Dis Child Fetal Neonatal Ed"],"accepted":{"date-parts":[[2017,9,28]]},"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To determine whether 2% chlorhexidine gluconate\u201370% isopropyl alcohol (CHX\u2013IA) is superior to 10% aqueous povidone\u2013iodine (PI) in preventing catheter-related blood stream infection (CR-BSI) when used to clean insertion sites before placing central venous catheters (CVCs) in preterm infants.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Randomised controlled trial.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Two neonatal intensive care units (NICUs).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Patients<\/jats:title>\n                  <jats:p>Infants &lt;31 weeks\u2019 gestation who had a CVC inserted.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Interventions<\/jats:title>\n                  <jats:p>Insertion site was cleaned with CHX\u2013IA or PI. Caregivers were not masked to group assignment.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Main outcome measures<\/jats:title>\n                  <jats:p>Primary outcome was CR-BSI determined by one microbiologist who was masked to group assignment. Secondary outcomes included skin reactions to study solution and thyroid dysfunction.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>We enrolled 304 infants (CHX\u2013IA 148\u2009vs PI 156) in whom 815 CVCs (CHX\u2013IA 384\u2009vs PI 431) were inserted and remained in situ for 3078 (CHX\u2013IA 1465\u2009vs PI 1613) days. We found no differences between the groups in the proportion of infants with CR-BSI (CHX\u2013IA 7%\u2009vs PI 5%, p=0.631), the proportion of CVCs complicated by CR-BSI or the rate of CR-BSI per 1000 catheter days. Skin reaction rates were low (&lt;1% CVC insertion episodes) and not different between the groups. More infants in the PI group had raised thyroid-stimulating hormone levels and were treated with thyroxine (CHX\u2013IA 0%\u2009vs PI 5%, p=0.003).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>We did not find a difference in the rate of CR-BSI between preterm infants treated with CHX\u2013IA and PI, and more infants treated with PI had thyroid dysfunction. However, our study was not adequately powered to detect a difference in our primary outcome and a larger trial is required to confirm our findings.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration<\/jats:title>\n                  <jats:p>This study was registered with the EU clinical trials register before the first patient was enrolled (Eudract 2011-002962-19). 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